Healthcare Provider Details

I. General information

NPI: 1346336484
Provider Name (Legal Business Name): ALLEN MEMORIAL HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 12/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 1/2 H AVE SUITE 3
GRUNDY CENTER IA
50638-1446
US

IV. Provider business mailing address

704 1/2 H AVE SUITE 3
GRUNDY CENTER IA
50638-1446
US

V. Phone/Fax

Practice location:
  • Phone: 319-824-6312
  • Fax: 319-824-5469
Mailing address:
  • Phone: 319-824-6312
  • Fax: 319-824-5469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN E KNOX
Title or Position: PRESIDENT / CEO
Credential:
Phone: 319-235-3987